<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">姓名:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-name" data-rule="required" class="form-control" name="row[name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">职称:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-title" class="form-control" name="row[title]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">类型:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="radio">
                <label>
                    <input name="row[staff_type]" type="radio" value="doctor" checked> 医生
                </label>
            </div>
            <div class="radio">
                <label>
                    <input name="row[staff_type]" type="radio" value="nurse" > 护士
                </label>
            </div>
            <div class="radio">
                <label>
                    <input name="row[staff_type]" type="radio" value="therapist" > 治疗师
                </label>
            </div>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">特长:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-specialty" class="form-control" name="row[specialty]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">证书编号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-license_number" class="form-control" name="row[license_number]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">从业年限:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-years_of_experience" class="form-control" name="row[years_of_experience]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">手机号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">密码:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-password" data-rule="required" class="form-control" name="row[password]" type="password">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">头像:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-avatar" data-rule="required" class="form-control" size="50" name="row[avatar]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-avatar" class="btn btn-danger faupload" data-input-id="c-avatar" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-avatar"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-avatar" class="btn btn-primary fachoose" data-input-id="c-avatar" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-avatar"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-avatar"></ul>
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">个人介绍:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-introduction" class="form-control editor" rows="5" name="row[introduction]" cols="50"></textarea>
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">是否在岗:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="radio">
                <label>
                    <input name="row[on_duty]" type="radio" value="1" checked> 在岗
                </label>
            </div>
            <div class="radio">
                <label>
                    <input name="row[on_duty]" type="radio" value="0" > 离岗
                </label>
            </div>
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">权重:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-weigh" data-rule="required" class="form-control" name="row[weigh]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">上门费用:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-price" class="form-control" name="row[price]" type="text">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <input type="hidden" name="row[hospital_id]" value="{$hospital_id}">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
